ADVISING TO COMMIT ABOR TION. The New York Penal Code provides that a person who with intent thereby to procure the miscarriage of a woman advises her to take any medicine, drug or substance is guilty of abortion. distinguished specialists sometimes live | figure many a good-looking house.very high up, in great apartment houses N. Y. Med. Record. without elevators. But some of the great Paris physicians live magnificently in town, and have fine country places as well. Along the Quai d'Orsay and the Quai Voltaire are noble houses, now used for business and other purposes, and formerly occupied by Nélaton and Trousseau. But the great men of the present in Paris live on the other side of the Seine. Why they do it, it is hard to say, for everything is very inviting still in the skirts of the Latin Quarter; and in the old Quarter itself, the new boulevards have destroyed all the intricacy and griminess of the region. Philadelphia and Boston outdo New York in the magnitude and splendor of door-plates and office-signs. It is doubtful if they are ever of any particular use, except for those who are looking for a doctor in an emergency, and a very simple indication would be as well as the great sprawling tin, or black marble, or brass affairs that dis The A curious result of this enactment in a recent case, was that a person was convicted when no abortion whatever was committed on the woman. offender advised the use of a certain drug, but this advice was not acted on nevertheless, an indictment was found and a conviction obtained. The Genera Term of the Supreme Court, in review ing the trial, held that the word "advises" in the law meant advice which was acted upon and not that which resulted in nothing. In conse quence the conviction was set aside.Weekly Med. Review. Cincinnati Sanitarium A PRIVATE HOSPITAL FOR THE INSANE. OHIO. Fifteen years successful operation. One hundred and fifty patients admitted annually Daily average, sixty. Cottage for nervous invalids, opium habit, etc. Location salubrious Surroundings delightful. Appliances ample. Charges reasonable. Accessible by rail; si trains daily; forty minutes from C. H. & D. Depot, cor. 5th and Hoadly Sts., Cincinnati. For particulars address, ORPHEUS EVERTS, M.D., Supt., ČOLLEGE HILL, OHIO ESSENCE OF Tancet-Clinic MOLIERE AND GUI PATIN.-Chapter III. By Thomas C. 398 Cystitis Treated by Injections of Corrosive Sublimate. -Viburnum Prunifolium in Cramps of the Leg See Advertisement “ VIN MARIANI” on Insert page x. "TO LESSEN THE FEVER AND STRENGTHEN THE HEART IS THE FIRST DUTY." SEE BROCHURE FOR FORMULE, PROFESSIONAL TESTIMONY, &c. SULTAN DRUG CO., ST. LOUIS AND LONDON. A New Invention. PATENT ALLOWED. THE AXION ELASTIC TRUSS Is worn with comfort NIGHT and DAY. It has N METAL SPRINGS to torture the patient or to injure the back. It sets snugly around the body and cannot b shifted by the most violent exercise. We guarantee it to hold with comfort the wors case of hernia, under all circumstances. IT IS WORN WITH EASE BY THE INFANT, THE DELICATE LADY, Capable of the most PERFECT ADJUSTMENT. THE its gynecological members, when they attempted to show how Tait repaired the perineum. I was one of those unAND satisfactory demonstrators, and now am sure that not one member, aside from the successive gentlemen with chalk in hand, went away the wiser. To see the Tait operation made by an inex TIME FOR REPAIRING THE LACERATED PERINEUM. A Paper read before the Academy of Medi- perienced hand is as worthless as some cine, January 25, 1892, BY EDWIN RICKETTS, M.D., CINCINNATI. Of all primiparal deliveries, about 33 per cent. are lacerated to a more or less degree. More women are lacerated between the years of sixteen and twenty, from twenty-five to thirty-five years coming next. It is claimed that women possessed of dark hair, red cheeks, red lips and bright, clear skin are most liable to tear, while those blondes who have sallow skin, with a tendency toward a deposit of pigment, are least vulnerable. My preference of the many methods in vogue for the repair of the lacerated perineum is that of flap-splitting, as revived by Mr. Lawson Tait. The important points to be considered are: 1. Simplicity. 2. Absence of loss of tissue. 3. The obtaining of muscle union. The literature and wood-cuts aiming to show the merits of each operator's modification, described in the journals and pamphlets, are as numerous as the different shaped pessaries for the restoration of the poor crooked uterus, so that its perpendicular line may correspond exactly with that of the spinal column. The literature and wood-cuts have been, to the reader, about as unsatisfactory as was the blackboard chalk-talk to this society recently by of our so-called wordy methods of gaining knowledge. Now, as to a recent criticism on Tait's method-that of the gaping of the skin outward and to the gaping of the mucous membrane into the vagina-it is no objection in the hands of operators who make frequent operations, as they soon learn how to overcome the objectionable gaping by not dissecting under the skin and mucous membrane too far. We have recently had a most valuable demonstration before this society, on the special manikin, of the Tait operation for the repair of the perineum, while one of our members recently demonstrated the same operation, by invitation, before a body of physicians in the city of Boston. These In perusing the literature on this subject, I have been surprised to see that position for the patient and time for the repair of the perineum have have hardly been mentioned. are the two greatest essentials to the surgical part, and Mr. Tait will never do this operation unless the patient be in the position that I shall attempt to describe later on. This way of placing the patient on the back, having an assistant to hold each lower extremity flexed on itself, is as unsatisfactory in holding tautly the perineal tissues as it is often injurious to the patient, as the assistants are apt to become tired from long standing and unconsciously lean on and bear down the flexed members on the body. To hold is a most difficult task, and in doing the same valuable light is frequently shut out, while in the holding it is almost an impossibility for the position of each limb to be equal. or wire has been tied too tightly, causing stitch abscess. In those cases in which there is laceration of the perineum, complicated by trauma of the pelvic floor posterior to the laceration, with prospects of a post-puerperal peritonitis that may be the result of a ruptured pus-tube or leaky ovarian or intra-ligamentous cyst, the primary repair of the perineum should not be attempted. In laceration pure and simple, while the risks of infection resulting from the bathing of the recently stitched field of operation in lochia are not so great as in the condition just mentioned, yet the difficulty in the after-dealing with this lochia, with the added risks that must necessarily follow the needle punctures, are in themselves enough to justify us in choosing a secondary repair of the perineum. The device that I now present (the Clover crutch) is the best apparatus for holding the leg in the proper position without fear of injury to the patient, bringing the field of operation best into. view, putting the tissues on the stretch, and doing away with two assistants. With this crutch, at most, all persons that are needed are the operator and anæsthetizer, with a nurse for the aftercare of the patient. With this crutch adjusted, the patient on her back and across the bed, her hips resting well on the edge, the bowels having been previously unloaded, thoroughly douching the vagina and rectum with warm water, the second essential position is that the knees be separated to a desirable extent. This slotted sliding-bar CYSTITIS TREATED BY INJECTIONS with the adjustable set-screw enables the operator to accomplish this in a most desirable manner. Now, as to the best time for secondary operations. I have followed up with care some of these operations in my earlier work and that of others, and find that many of the results are simply plastic, and that, of the poorest kind. More especially has this been true of the primary operations. I found that much attention had been paid to the cosmetic skin union, while no consequential result had been obtained in muscle union. In some instances the union did not extend beyond the skin. In some a small part of the muscle had united, and in others there had been but slight union. In primary repairs it is almost an impossibility to keep the lochia from coming in contact with the pre-stitched and post-stitched field of operation. This, with the added needle-hole punctures and the tendency of this lochia to work itself through the silk medium into the post-stitched field, makes it exceedingly difficult to not infect the patient. This is more liable to occur in those cases where the silkworm-gut [FOR DISCUSSION see p. 396]. OF CORROSIVE SUBLIMATE. Prof. Guyon, of Paris, France (Annales de Médecine générale, No. 1, 1892), has made extensive studies with the application of intra-vesical injections of solutions of corrosive sublimate in concentrations of 1 : 5,000 to 1: 1,000. He also used it by instillation into the bladder through the posterior urethra (thirty to one hundred drops). This treatment gave excellent results in painful tuberculous cystitis, where especially the nitrate of silver is not well supported; the frequent urination ceased and the capacity of the bladder much increased. In gonorrheal cystitis this treatment seems to have no advantage over the employment of the nitrate of silver. VIBURNUM PRUNIFOLIUM IN This remedy is recommended (Medizinische Neuigkeiten, No. 2, 1892) in the treatment of nocturnal cramps in the legs. Three to five grains (fortyfive drops to one drachm) may be given at a dose.-[Pritchard. |